EENT Exam Questions With Complete
Solutions
A |22-year-old |woman |presents |with |a |1-year |history |of |flaking |and |scaling |around |her |lashes, |
along |with |itching |and |a |burning |sensation. |She |has |also |noted |her |lid |margins |are |red, |and |
some |of |her |lashes |are |missing.
Her |history |is |significant |for |diabetes |and |for |seborrheic |dermatitis |of |the |scalp, |eyebrows, |and
|external |ears.
Question
What |is |the |most |likely |diagnosis?
Blepharitis
Chalazion
Conjunctivitis
Ectropion
Foreign |body
Blepharitis
A |78-year-old |Caucasian |man |presents |with |unilateral |painless |loss |of |vision |in |the |right |eye |of
|3 |hours |duration. |Examination |reveals |an |elderly |man |who |is |anxious |but |in |no |acute |distress.
|Visual |acuity |is |light |perception |only |in |the |right |eye |and |20/30 |in |the |left |eye. |Pupillary |
examination |is |significant |for |an |afferent |pupillary |defect |on |the |right |side. |Penlight |
examination |of |the |eyes |is |otherwise |unremarkable. |Retinal |examination |of |the |right |eye |
reveals |a |cherry-red |spot. |Retinal |examination |of |the |left |eye |is |unremarkable.
Question
What |disease |process |most |likely |accounts |for |the |patient's |presentation?
Adult-onset |Tay-Sachs |disease
Open-angle |glaucoma
,Central |retinal |artery |occlusion
Trauma
Cataract
Central |retinal |artery |occlusion
A |30-year-old |Black |male |patient |is |admitted |to |the |hospital |to |undergo |stapedectomy |for |the |
treatment |of |otosclerosis. |He |has |experienced |increased |hearing |loss |in |the |right |ear |for |a |few
|years. |The |patient's |mother |had |had |the |same |condition |when |she |was |in |her |40s, |and |she |
underwent |a |successful |operation. |Assessment |is |performed |using |the |Weber |and |Rinne |tests.
Question
What |physical |exam |finding |is |expected?
Bone |conduction |of |the |affected |side |is |greater |than |air |conduction.
Bone |conduction |of |the |affected |side |is |equal |to |air |conduction.
Air |conduction |of |the |affected |side |is |greater |than |bone |conduction.
Sound |lateralizes |to |the |unaffected |ear.
Bone |conduction |of |the |unaffected |ear |is |greater |than |air |conduction.
Bone |conduction |of |the |affected |side |is |greater |than |air |conduction
A |41-year-old |woman |presents |to |the |local |emergency |department |with |a |14-day |history |of |
nasal |drainage, |congestion, |fever, |and |cheek |pain. |She |was |started |on |amoxicillin/clavulanate |
initially, |but |she |was |switched |to |levofloxacin |7 |days |ago |due |to |no |improvement |in |
symptoms. |After |7 |days |of |levofloxacin |therapy, |she |presents |again, |reporting |that |she |is |no |
better. |The |fever |continues |and |she |now |has |upper |tooth |pain. |On |exam, |she |is |in |mild |
distress, |with |thick |purulent |rhinorrhea |and |halitosis.
Question
What |is |the |next |step |in |the |care |of |this |patient?
Admission |for |intravenous |antibiotics
Continue |current |therapy |for |an |additional |10 |days
Switch |to |a |broad |spectrum |antibiotic
Refer |to |ENT |for |sinus |aspiration
Sinus |surgery
,Refer |to |ENT |for |sinus |aspiration
A |44-year-old |man |presents |for |follow-up |of |poorly |controlled |type |1 |diabetes |mellitus |that |
was |diagnosed |32 |years |ago. |What |change |on |his |funduscopic |examination |would |indicate |a |
need |for |urgent |referral |to |an |ophthalmologist?
Blot |hemorrhages
Cotton |wool |spots
Microaneurysms
Neovascularization
Flame-shaped |hemorrhages
Neovascularization
A |42-year-old |man |presents |with |a |firm |painless |bump |on |his |left |upper |eyelid. |On |
examination, |you |note |a |5 |mm |mass |within |the |tarsus |of |the |left |eye. |The |skin |is |freely |
movable |over |the |mass. |The |remainder |of |the |eye |exam |is |unremarkable.
Question
What |is |the |most |likely |diagnosis?
Pterygium
Ectropion
Hordeolum
Chalazion
Xanthelasma
Chalazion
A |25-year-old |male |patient |presents |with |an |acute |otitis |media |with |serous |otitis |in |the |right |
ear. |Weber |and |Rinne |tests |are |performed.
Question
What |results |are |expected?
A |Weber—sound |is |heard |louder |in |right |ear; |Rinne—bone |conduction |exceeds |air |conduction
|in |right |ear
B |Weber—sound |is |heard |louder |in |left |ear; |Rinne—bone |conduction |exceeds |air |conduction |
in |right |ear
, C |Weber—sound |is |heard |louder |in |right |ear; |Rinne—air |conduction |exceeds |bone |conduction |
in |right |ear
D |Weber—sound |is |heard |louder |in |left |ear; |Rinne—air |conduction |exceeds |air |conduction |in |
right |ear
E |Weber—sound |is |equal |in |both |ears; |Rinne—bone |conduction |greater |than |air |conduction |in
|right |ear
C |Weber—sound |is |heard |louder |in |right |ear; |Rinne—bone |conduction |exceeds |air |conduction |
in |right |ear
A |67-year-old |woman |presents; |according |to |her, |her |husband |says |she |never |listens |to |
anything |he |says. |The |patient |states |that |occasionally |she |has |to |ask |people |to |repeat |
themselves |when |sitting |to |her |right. |She |denies |any |dizziness, |headaches, |or |visual |
disturbances. |Her |current |medication |is |furosemide. |On |physical |examination, |the |Weber |test |
reveals |lateralization |to |the |left |ear. |On |the |left |ear, |air |conduction |lasted |for |15 |seconds |and |
bone |conduction |lasted |10 |seconds. |On |the |right |ear, |air |conduction |lasted |for |22 |seconds |and
|bone |conduction |lasted |10 |seconds.
Question
What |is |the |most |likely |cause |of |this |hearing |loss?
Cerumen |impaction
Otosclerosis
Ototoxicity
Ménière's |disease
Middle |ear |effusion
Ototoxicity
A |35-year-old |woman |presents |with |a |painful |swelling |of |her |left |eyelid. |On |physical |exam, |
there |is |tenderness |to |palpation |and |erythematous |swelling |present |on |the |lid |margin |
involving |the |eyelashes.
Question
What |is |the |most |likely |diagnosis?
Xanthelasma
Chalazion
Solutions
A |22-year-old |woman |presents |with |a |1-year |history |of |flaking |and |scaling |around |her |lashes, |
along |with |itching |and |a |burning |sensation. |She |has |also |noted |her |lid |margins |are |red, |and |
some |of |her |lashes |are |missing.
Her |history |is |significant |for |diabetes |and |for |seborrheic |dermatitis |of |the |scalp, |eyebrows, |and
|external |ears.
Question
What |is |the |most |likely |diagnosis?
Blepharitis
Chalazion
Conjunctivitis
Ectropion
Foreign |body
Blepharitis
A |78-year-old |Caucasian |man |presents |with |unilateral |painless |loss |of |vision |in |the |right |eye |of
|3 |hours |duration. |Examination |reveals |an |elderly |man |who |is |anxious |but |in |no |acute |distress.
|Visual |acuity |is |light |perception |only |in |the |right |eye |and |20/30 |in |the |left |eye. |Pupillary |
examination |is |significant |for |an |afferent |pupillary |defect |on |the |right |side. |Penlight |
examination |of |the |eyes |is |otherwise |unremarkable. |Retinal |examination |of |the |right |eye |
reveals |a |cherry-red |spot. |Retinal |examination |of |the |left |eye |is |unremarkable.
Question
What |disease |process |most |likely |accounts |for |the |patient's |presentation?
Adult-onset |Tay-Sachs |disease
Open-angle |glaucoma
,Central |retinal |artery |occlusion
Trauma
Cataract
Central |retinal |artery |occlusion
A |30-year-old |Black |male |patient |is |admitted |to |the |hospital |to |undergo |stapedectomy |for |the |
treatment |of |otosclerosis. |He |has |experienced |increased |hearing |loss |in |the |right |ear |for |a |few
|years. |The |patient's |mother |had |had |the |same |condition |when |she |was |in |her |40s, |and |she |
underwent |a |successful |operation. |Assessment |is |performed |using |the |Weber |and |Rinne |tests.
Question
What |physical |exam |finding |is |expected?
Bone |conduction |of |the |affected |side |is |greater |than |air |conduction.
Bone |conduction |of |the |affected |side |is |equal |to |air |conduction.
Air |conduction |of |the |affected |side |is |greater |than |bone |conduction.
Sound |lateralizes |to |the |unaffected |ear.
Bone |conduction |of |the |unaffected |ear |is |greater |than |air |conduction.
Bone |conduction |of |the |affected |side |is |greater |than |air |conduction
A |41-year-old |woman |presents |to |the |local |emergency |department |with |a |14-day |history |of |
nasal |drainage, |congestion, |fever, |and |cheek |pain. |She |was |started |on |amoxicillin/clavulanate |
initially, |but |she |was |switched |to |levofloxacin |7 |days |ago |due |to |no |improvement |in |
symptoms. |After |7 |days |of |levofloxacin |therapy, |she |presents |again, |reporting |that |she |is |no |
better. |The |fever |continues |and |she |now |has |upper |tooth |pain. |On |exam, |she |is |in |mild |
distress, |with |thick |purulent |rhinorrhea |and |halitosis.
Question
What |is |the |next |step |in |the |care |of |this |patient?
Admission |for |intravenous |antibiotics
Continue |current |therapy |for |an |additional |10 |days
Switch |to |a |broad |spectrum |antibiotic
Refer |to |ENT |for |sinus |aspiration
Sinus |surgery
,Refer |to |ENT |for |sinus |aspiration
A |44-year-old |man |presents |for |follow-up |of |poorly |controlled |type |1 |diabetes |mellitus |that |
was |diagnosed |32 |years |ago. |What |change |on |his |funduscopic |examination |would |indicate |a |
need |for |urgent |referral |to |an |ophthalmologist?
Blot |hemorrhages
Cotton |wool |spots
Microaneurysms
Neovascularization
Flame-shaped |hemorrhages
Neovascularization
A |42-year-old |man |presents |with |a |firm |painless |bump |on |his |left |upper |eyelid. |On |
examination, |you |note |a |5 |mm |mass |within |the |tarsus |of |the |left |eye. |The |skin |is |freely |
movable |over |the |mass. |The |remainder |of |the |eye |exam |is |unremarkable.
Question
What |is |the |most |likely |diagnosis?
Pterygium
Ectropion
Hordeolum
Chalazion
Xanthelasma
Chalazion
A |25-year-old |male |patient |presents |with |an |acute |otitis |media |with |serous |otitis |in |the |right |
ear. |Weber |and |Rinne |tests |are |performed.
Question
What |results |are |expected?
A |Weber—sound |is |heard |louder |in |right |ear; |Rinne—bone |conduction |exceeds |air |conduction
|in |right |ear
B |Weber—sound |is |heard |louder |in |left |ear; |Rinne—bone |conduction |exceeds |air |conduction |
in |right |ear
, C |Weber—sound |is |heard |louder |in |right |ear; |Rinne—air |conduction |exceeds |bone |conduction |
in |right |ear
D |Weber—sound |is |heard |louder |in |left |ear; |Rinne—air |conduction |exceeds |air |conduction |in |
right |ear
E |Weber—sound |is |equal |in |both |ears; |Rinne—bone |conduction |greater |than |air |conduction |in
|right |ear
C |Weber—sound |is |heard |louder |in |right |ear; |Rinne—bone |conduction |exceeds |air |conduction |
in |right |ear
A |67-year-old |woman |presents; |according |to |her, |her |husband |says |she |never |listens |to |
anything |he |says. |The |patient |states |that |occasionally |she |has |to |ask |people |to |repeat |
themselves |when |sitting |to |her |right. |She |denies |any |dizziness, |headaches, |or |visual |
disturbances. |Her |current |medication |is |furosemide. |On |physical |examination, |the |Weber |test |
reveals |lateralization |to |the |left |ear. |On |the |left |ear, |air |conduction |lasted |for |15 |seconds |and |
bone |conduction |lasted |10 |seconds. |On |the |right |ear, |air |conduction |lasted |for |22 |seconds |and
|bone |conduction |lasted |10 |seconds.
Question
What |is |the |most |likely |cause |of |this |hearing |loss?
Cerumen |impaction
Otosclerosis
Ototoxicity
Ménière's |disease
Middle |ear |effusion
Ototoxicity
A |35-year-old |woman |presents |with |a |painful |swelling |of |her |left |eyelid. |On |physical |exam, |
there |is |tenderness |to |palpation |and |erythematous |swelling |present |on |the |lid |margin |
involving |the |eyelashes.
Question
What |is |the |most |likely |diagnosis?
Xanthelasma
Chalazion
